title: Efficacy of low molecular weight heparin in patients with acute exacerbation of chronic obstructive pulmonary disease receiving ventilatory support.
abstract: BACKGROUND
  Severe and acute exacerbation of chronic obstructive pulmonary disease (COPD) is associated with a high mortality. Since COPD is an airway inflammatory disease, and heparin has shown anti-inflammatory effects in previous studies, we evaluated the clinical effect of low molecular weight heparin (LMWH; nadroparin) in COPD patients admitted into the hospital due to acute exacerbations.
  
  
  METHODS
  Sixty-six patients admitted to the intensive care unit (ICU) were randomly divided into control group (n = 33) and LMWH group (n = 33). The control group received conventional treatment, including oxygen therapy (non-invasive or conventional mechanical ventilation), anti-infection, atomization expectorant, spasmolysis, anti-asthmatics, and nutritional support. The LMWH group received the same treatment plus LMWH for 1 week. The levels of plasma C-reactive protein, interleukin-6, and fibrinogen were measured. The main outcomes were duration of mechanical ventilation, length of ICU stay, and hospital stay.
  
  
  RESULTS
  There were no significant differences between the groups with respect to demographics, severity of illness, and gas exchange variables. The levels of plasma C-reactive protein, interleukin-6, and fibrinogen were significantly decreased in the LMWH group. LMWH significantly reduced the mean duration of mechanical ventilation (6.6 days vs. 3.8 days; p < 0.01), the length of ICU stay (8.5 days vs. 5.6 days; p < 0.01) and hospital stay (14.3 days vs. 11.3 days; p < 0.01).
  
  
  CONCLUSIONS
  The addition of LMWH to standard therapy benefits COPD patients with acute exacerbation.
authors.affiliation: Department of Critical Care Medicine, Affiliated First People's Hospital, Shanghai Jiao Tong University School of Medcine , Shanghai , China.
authors.forename: Yongbing
authors.initials: Y
authors.lastname: Qian
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.forename: Rui
authors.initials: R
authors.lastname: Tian
authors.forename: Kanglong
authors.initials: K
authors.lastname: Yu
authors.forename: Ruilan
authors.initials: R
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017762:Nadroparin / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000628:therapy*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D017762:Nadroparin